Medical Care of the Liver Transplant Patient, 4E builds on the success of previous editions, by once again providing hepatologists with the most up to date clinical assessment book on how to best to monitor and treat the liver transplant recipient, both pre-, during and post-operatively. The Editors have ensured the emphasis throughout is on practical advice on complete patient management, and haveassembled an international mix of experienced contributors, including a large proportion from the US. This new edition is clearly arranged into 5 sections, highlighting initial indication and selection of the potential recipient, management of the donor organ, post-operative complications in the patient through to acute recovery, long-term follow-up and continued health. The overriding aim is to provide the user a complete guide as to the correct clinical management of both the recipient and the donor organ for all the various stages of transplantation. With a host of new chapters, and with each chapter containing 10 MCQ's as well as key learning objectives from the AASLD, this new edition will be essential reading for all hepatologists, gastroenterologists, transplant surgeons, transplant nurses and GI nurses treating and managing patients requiring liver transplantation. Photos: 25 B&W, 0 Color; Drawings: 35 B&W, 0 Color

Pierre-Alain Clavien, MD, PhD, FACS, FRCS (Eng), FRCS (Ed), Professor and Chairman, Department of Surgery. Head, Division of Visceral & Transplantation Surgery, University Hospital Zurich, Switzerland
Professor Clavien is a world-wide renowned surgeon-scientist, currently professor and chairman of the Department of Surgery in Zurich, Switzerland. His areas of research include organ preservation, liver ischemia-reperfusion injury and regeneration, and pathogenesis of cancer, as well as outcome research. He received many competitive grants and awards, including one of the most prestigious prices for scientific research, the Otto Naegeli Award.

Dr James Trotter is the Medical Director of Liver Transplantation at Baylor University Medical Center at Dallas. Dr. Trotter's primary interests include end-stage liver disease and the management of liver transplant candidates and recipients. Dr. Trotter specializes in hepatitis C, ascites, complications of portal hypertension, including esophageal varices and hepatic encephalopathy. He also has vast experience in the management of medical complications after liver transplantation including immunosuppression in liver transplant recipients and the treatment of hepatitis C before and after liver transplantation.

Contributors, ix

Preface, xv

Part 1 Management of the potential transplant recipient

1 Selection and evaluation of the recipient (including retransplantation), 3
Audrey Coilly and Didier Samuel

2 Monitoring the patient awaiting liver transplantation, 13
Andreas Geier and Beat Müllhaupt

3 Management of portal hypertension, 26
Juan Carlos Garcia-Pagan, Juan G. Abraldes and Jaime Bosch

4 Management of renal disease in the liver transplant candidate, 39
Andrés Cárdenas and Pere Ginès

5 Management of hepatopulmonary syndrome and portopulmonary hypertension, 51
Victor I. Machicao and Michael B. Fallon

6 Psychiatric and substance abuse evaluation of the potential liver transplant recipient, 62
Thomas P. Beresford

7 Organ allocation in liver transplantation: ethics, organ supply, and evidencebased practice, 75
Nicole Siparsky, David Axelrod and Richard B. Freeman

8 Viral hepatitis and transplantation, 88
Geoffrey W. McCaughan

9 Metabolic liver diseases, 97
Maureen M.J. Guichelaar and Michael R. Charlton

10 Cholestatic and autoimmune liver disease, 110
Ulrich Beuers

11 Hepatocellular carcinoma, 121
Maria Reig, Alejandro Forner and Jordi Bruix

12 Cholangiocarcinoma, 133
Howard C. Masuoka, Gregory J. Gores and Charles B. Rosen

13 Rare indications for liver transplantation, 145
Stevan A. Gonzalez

14 Liver transplantation in HIV patients, 155
Marion G. Peters and Peter G. Stock

15 Living-donor liver transplantation, 162
Robert S. Brown Jr

16 Fulminant hepatic failure, 176
Michael A. Heneghan and William Bernal

Part 2 Donor issues and management in the perioperative period

17 Extended-criteria donor, 191
Ashraf Mohammad El-Badry and Mickael Lesurtel

18 Liver transplantation using donors after cardiac death, 201
Paolo Muiesan, Laura Tariciotti and Chiara Rocha

19 Transmission of malignancies and infection through donor organs, 216
Aaron M. Winnick and Lewis Teperman

20 The transplant operation, 229
Philipp Dutkowski, Olivier de Rougemont and Pierre-Alain Clavien

21 Difficult surgical patients, 238
Philipp Dutkowski, Stefan Breitenstein and Pierre-Alain Clavien

22 Domino and split-liver transplantation, 246
Abhideep Chaudhary and Abhinav Humar

23 Surgical aspects of living-donor transplantation, 255
Kelvin K.C. Ng and Sheung Tat Fan

24 Anesthesia, 266
Beatrice Beck-Schimmer

25 Coagulation and blood transfusion management, 276
Herman G.D. Hendriks, Ton Lisman and Robert J. Porte

26 Critical care of the liver transplant recipient, 286
Markus Béchir, Erik Schadde and Philipp Dutkowski

27 Rejection and immunosuppression trends in liver transplantation, 297
James F. Trotter

28 Vascular complications after liver transplantation, 311
Goran Klintmalm and Srinath Chinnakotla

29 Biliary complications following liver transplantation, 319
Sanna op den Dries, Robert C. Verdonk and Robert J. Porte

30 Role of histopathology, 332
Achim Weber

Part 3 Chronic problems in the transplant recipient

31 Medical problems after liver transplantation, 347
Eberhard L. Renner and Marco Puglia

32 Prevention and treatment of recurrent HBV and HCV infection, 361
Ed Gane

33 Recurrence of the original disease, 372
James Neuberger

34 Infections in the liver transplant recipient, 380
Nicolas J. Mueller and Jay A. Fishman

35 Cutaneous diseases in liver transplant recipients, 389
Sylvie Euvrard and Jean Kanitakis

36 Post-transplant lymphoproliferative disorder and other malignancies after liver transplantation, 398
Natasha Chandok and Kymberly D.S. Watt

37 Sexual function and fertility after liver transplantation, 406
Andreas Geier and Beat Müllhaupt

Part 4 Pediatric liver transplantation

38 Special considerations in pediatric liver transplantation, 419
Brandy Ries Lu and Ronald J. Sokol

Multiple choice questions, 431

Answers, 446

Index, 451